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ANAK LAMPIRAN 1 PERATURAN KEPALA BADAN

KEPEGAWAIAN NEGARA
NOMOR : 12 TAHUN 2011
TANGGAL : 28 JUNI 2011

FORMULIR
ANALISIS JABATAN

(Isilah formulir ini sesuai dengan data yang sebenarnya)

1. Nama Jabatan : .......................................................................................................

2. Kode Jabatan : ......................................................................................................

3. Unit Kerja :

Eselon I : ......................................................................................................

Eselon II : ......................................................................................................

Eselon III : ......................................................................................................

Eselon I V : ......................................................................................................

4. Kedudukan Dalam Struktur Organisasi :

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5. Ikhtisar Jabatan :

................................................................................................................................

.................................................................................................................................

.................................................................................................................................

6. Uraian Tugas:
a. .........................................................................................................................

b. .........................................................................................................................

c. Dst.

7. Bahan Kerja :

No Bahan Kerja Penggunaan Dalam Tugas

1.

2.

3.
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8. Perangkat/ Alat Kerja:

N
Perangkat Kerja Digunakan Untuk Tugas
o
1.

2.

3.
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9. Hasil Kerja:

N Jumlah
Hasil Kerja Waktu Yang Diperlukan
o Satuan
1.

2.

3.

10. Tanggung Jawab:

a. ...........................................................................................................................
b. ...........................................................................................................................
c. ...........................................................................................................................
d. ...........................................................................................................................

Catatan:
Kata kunci (keakuratan, kelancaran, kerahasiaan, kebenaran, kesesuaian,
ketepatan, keselamatan, kerapihan, keamanan, kualitas, kuantitas, keutuhan,
kelengkapan, keefektifan, kelayakan, keindahan, keharmonisan).

11. Wewenang:
a. ............................................................................................................................
b. ............................................................................................................................
c. ............................................................................................................................
............................................................................................................................
............................................................................................................................
d. ............................................................................................................................

Catatan :
Kata kunci (meminta, menolak, memberikan, memutuskan, mengeluarkan,
menggunakan, menentukan, menetapkan, menegur, memotivasi, menilai).

12. Korelasi Jabatan:

No Jabatan Unit Kerja/ Instansi Dalam Hal

1.

2.
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3.

13. Kondisi Lingkungan Kerja:

No Aspek Faktor

1. Tempat kerja

2. Suhu

3. Udara

4. Keadaan Ruangan

5. Letak

6. Penerangan

7. Suara

8. Keadaan tempat kerja

9. Getaran

14. Resiko Bahaya:

No Fisik / Mental Penyebab

1.

2.

3.

15. Syarat Jabatan:

a. Pangkat/Gol. Ruang :.....................................................................................

b. Pendidikan :.....................................................................................

c. Kursus/Pelatihan
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1) Penjenjangan :.....................................................................................

2) Teknis :....................................................................................

d. Pengalaman kerja :....................................................................................

e. Pengetahuan kerja :...................................................................................

f. Keterampilan kerja :...................................................................................

g. Bakat Kerja :

1) ...................................................................................................................
2) ...................................................................................................................
3) ...................................................................................................................

Catatan :
Tuliskan faktor-faktor bakat kerja seperti yang terdapat dalam Anak
Lampiran 2 Tabel 2.1, yang dianggap dominan pada fungsi pekerja
tersebut.

h. Temperamen Kerja :

1).....................................................................................................................
2).....................................................................................................................
3) ....................................................................................................................

Catatan :
Tuliskan faktor-faktor temperamen kerja seperti yang terdapat dalam
Anak Lampiran 2 Tabel 2.2, yang dianggap dominan pada fungsi pekerja
tersebut.

i. Minat Kerja :

1) ..................................................................................................................
2) ..................................................................................................................
3) ..................................................................................................................

Catatan :
Tuliskan faktor-faktor minat kerja seperti yang terdapat dalam Anak
Lampiran 2 Tabel 2.3, yang dianggap dominan pada fungsi pekerja
tersebut.
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j. Upaya Fisik :

1).....................................................................................................................
2).....................................................................................................................
3).....................................................................................................................

Catatan :
Tuliskan faktor-faktor upaya fisik seperti yang terdapat dalam Anak
Lampiran 2 Tabel 2.4, yang dianggap dominan pada fungsi pekerja
tersebut.

k. Kondisi Fisik :

1) Jenis Kelamin : ...................................................................................

2) Umur : ...................................................................................

3) Tinggi badan : ...................................................................................

4) Berat badan : ...................................................................................

5) Postur badan : ...................................................................................

6) Penampilan : ...................................................................................

l. Fungsi Pekerja :

1) ...................................................................................................................
2) ...................................................................................................................
3) ...................................................................................................................

Catatan :
Tuliskan faktor-faktor fungsi pekerja seperti yang terdapat dalam Anak
Lampiran 2 Tabel 2.5, yang dianggap dominan pada fungsi tersebut.
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16. Prestasi Kerja Yang Diharapkan

Jumlah
No Hasil Kerja Waktu Yang Diperlukan
Satuan

1.

2.

3.

17. Butir Informasi Lain :

..............................................................................................................................

..............................................................................................................................

..............................................................................................................................

....................., ....................201..

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